Fellner, Dietrich Albert

Fellner, Dietrich Albert is an individual health care provider with primary practice located at 813 Independence Blvd , Virginia Beach VA 23455-6004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Fellner, Dietrich Albert can be contacted via phone (757) 490-9091.

Contact Information

Primary practice address
813 Independence Blvd Virginia Beach VA 23455-6004
Fax: (757) 490-3250
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101232452 Virginia

Profile Details

NPI number 1922097179
LBN Legal business name Fellner, Dietrich Albert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated May 9th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922097179 NPPES
Virginia Other 110252 ANTHEM BLUE CROSS
Virginia Other 541206650 ANTHEM BLUE CROSS
Virginia MEDICAID 010030013 ANTHEM BLUE CROSS

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